젊은 성인에서 흡연에 의한 상완동맥 내피기능의 부전에 관한 연구

이상철,권영주,방덕원,이선해,이보영,김지욱,김영훈,온영근,현민수,김성구 순천향의학연구소 2002 Journal of Soonchunhyang Medical Science Vol.8 No.1

Background and Objectives : Cigarette smoking is a major factor and the most modifiable risk factor for atherosclerosis. Endothelial dysfunction is an early event in atherosclerosis, before the structural change of the systemic arteries. We hypothesized that endothelial dysfunction might be present in the systemic arteries of young adult smokers and that this might be dose-dependent phenomenon. Therefore, we try to certify that smoking is associated with endothelial dysfunction in healthy young adults without other risk factor of atherosclerosis. Subjects and Methods : we studied noninvasively 29 subjects aged 3 to 4 decades without other risk factor of atherosclerosis, they were composed of the two groups, current smokers(n=15) and nonsmokers(n=14). Smoking history varied from 3 to 20 pack years. Using high-resolution ultrasound, vessel diameter and mean flow rate were measured at rest, during reactive hyperemia(with flow-mediated endothelium-dependent dilation), and after sublingual nitroglycerin(NG-induced endothelium-independent vasodilation). Result : Flow mediated endothelium dependent dilation was observed in the control subjects (9.4±3.44%) but was impaired in the smokers(5.8±2.51%)(p=0.004). NG-induced endothelium independent dilation is no difference in all subjects. Conclusion : Cigarette smoking is associated with endothelial dysfunction in healthy young adults.

Factors associated with the risk of colorectal neoplasia in young adults under age 40

Ilsoo Kim,Han Hee Lee,Young Jae Ko,Ho Eun Chang,Dae Young Cheung,Bo-In Lee,Young-Seok Cho,Jin Il Kim,Myung-Gyu Choi 대한내과학회 2022 The Korean Journal of Internal Medicine Vol.37 No.5

Background/Aims: Recent epidemiologic studies have shown a continued increase in colorectal cancer incidence among younger adults. Little is known about the factors that contribute to the development of young-onset colorectal neoplasia (CRN). Methods: A cross-sectional analysis was performed for individuals younger than 40 years who underwent colonoscopy in Seoul St. Mary’s Hospital and its affiliated health screening center. High-risk CRN was defined as adenoma or sessile serrated lesion ≥ 10 mm, with three or more adenomas, villous histology, high grade dysplasia, or carcinoma. Results: Of these 13,621 included participants, 2,023 (14.9%) had one and more CRN. Young patients with CRN tended to be elderly, male, obese, smoker, having a habit of drinking, and having comorbidities such as hypertension, dyslipidemia, diabetes, and chronic kidney disease. In a multivariate analysis adjusted for age, sex, obesity, smoking status, and alcohol intake, old age (odds ratio [OR], 1.086; 95% confidence interval [CI], 1.054 to 1.119), male sex (OR, 1.748; 95% CI, 1.247 to 2.451), obesity (OR, 1.439; 95% CI, 1.133 to 1.828), and smoking (OR, 1.654; 95% CI, 1.287 to 2.127) were independent risk factors for overall CRN. Obesity and smoking as two modifiable factors increased the risk for high-risk CRN even more than for overall CRN (OR, 1.734; 95% CI, 1.168 to 2.575 and OR, 1.797; 95% CI, 1.172 to 2.753, respectively). Conclusions: Obesity and smoking were modifiable risk factors for CRN in young adults. They increased the risk for highrisk CRN even more than for overall CRN. A colonoscopy might be beneficial for young individuals with these factors.

한국인에서 혈소판 당단백 Ⅱb/Ⅲa 유전자 다형성과 관동맥 성형술 후 재 협착과의 관계

이민수,이정우,김보영,임대승,강정아,김정희,김윤철,성보영,최성준,성인환,전은석 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.2

Platelet aggregation is the final pathway of acute coronary syndrome such as acute myocardial infarction and unstable angina. Platelet glycoprotein IIb/IIIa is a membrane receptor for fibrinogen and yon Willebrand factor and it plays an important role in platelet aggregation and in the pathogenesis of acute coronary syndrome. It is known that polymorphism of the gene that encoding platelet glycoprotein IIb/IIIa(PI^A1/A2) is strongly related to acute coronary syndrome in Caucasian, but not in Koreans. We investigated relationship between platelet glycoprotein llb/Illa gene polymorphism and restenosis of coronary artery after angioplasty in Koreans. Total 371 patients(M=251. F=120) were enrolled. Angioplasty group comprised 143 patients who underwent coronary angioplasty, and in the angioplasty group, restenosis group comprised with the 65 patients who had restenotic lesion over 50% of luminal diameter in follow-up coronary angiography. Normal group comprised 153 patients who had no significant angiographic lesion and variant angina group comprised 75 patients who were positive in ergonovine test. Genomic DNA was extracted from peripheral arterial blood. To determine the frequency of P1^A1/A2 genotype, polymerase chain reaction(PCR) was done and the product was restricted with Mspl. 3%. agarrose gel electrophoresis showed restriction fragment length polymorphism. Clinical profile and risk factor were also reviewed. Among all 371 patients of study group, genotype of only one patients in restenosis group if is proven to be PI^A1/A2 heterozygote. All patients of normal study group, no restenosis group, and the other patients in restenosis group have an PI^A1 homozygote genotype. In our study, platelet glycoprotein IIb/Illa polymorphism has no relationship with restenosis of the coronary artery after angioplasty in Koreans. But the genotypic frequency of platelet glycoprotein IIb/IIIa gene polymorphism in Koreans is concordant with that of previous studies.

남자 대학생의 동거 유무에 따른 에너지 섭취와 식습관의 비교

박영숙,이보경,이보숙 대한지역사회영양학회 2003 대한지역사회영양학회지 Vol.8 No.3

To investigate effects of the shared living on nutrient intakes, 250 college male students who were living alone (104men) or sharing accommodation with friends (134 men) were participated. Their average age was 22.6 years, their average height was 171.8 cm, their average weight was 65.6 kg and their average Body Mass Index (BMI) was 22.2. The caloric intakes of the men living alone or sharing accommodation were 55.9$ and 72.5$ of the korean Recommended Dietary Allowance (RDA), respectively. The decreased caloric level of the group living alone seemed to be due to their decreased protein and fat consumption as compared to that of the group sharing accommodation. The group living alone consumed increased amounts of fiber for breakfast and half the carbohydrates, but more fat (p<0.05) in snacks than the group sharing accommodation. The daily carbohydrate : protein : fat (C:P:F) ratio averaged 58.6 : 14.1 : 27.3, which is a lower carbohydrate and a higher fat ratio than the Korean recommended ratio. However, the group living alone was closer to the Korean recommended ratio than the group sharing accommodation. The food intake habits were evaluated as being poorer in the group living alone as compared to the group sharing accommodation, less frequent consumption of fried / pan-fried dishes, and fruits / juices, but more frequent consumption of instant / processed foods. In comparing the eating patterns of the two groups, the group living alone showed better eating habits, such as more "breakfast eating" and less "snacking in the morning, afternoon or late at night" whereas the group sharing accommodation showed better eating habits such as less "picky eaters" and less "eating out". In the group living alone, their lower caloric intake was assumably due to their fewer side dishes, however they showed higher eating frequencies of instant / processed foods. Since the lifestyle of living alone seems to grow gradually among young men, we strongly recommend dietary education for them.

열대 지역에서 통일형 초다수성 벼 품종의 생육 및 수량성 비교

이지윤,준현,성환,손영보,송유천,한상익,박동수,권영업,이철원,이종희 忠北大學校 農業科學硏究所 2015 農業科學硏究 Vol.31 No.2

관상동맥 스텐트 시술 후의 재협착에 관한 연구

김윤철,이정우,김보영,강정아,임대승,이민수,김정희,성보영,최성준,성인환,전은석 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

Coronary stent implacement is known as an effective treatment in the intimal dissection after percutaneous transluminal coronary angioplasty and the prevention of restenosis. However, In-stent restenosis still remains a major concern in clinical stenting. The stents were placed in 103 patients from July 1996 to March 1999 and performed follow-up coronary angiograms in 59(57.3%) patients. To identify the clinical, angiographic and procedurerelated variables 'which predict late restenosis within the stented artery, 59 patients(58.3±9.9, M:F= 41:18) were studied. The clinical characteristics of the patients were stable angina in 23(39.0%), unstable angina in 14(23.7%), acute myocardial infarction in 21(35.6%) and old myocardial infarction in 1(1.7%). Coronary stenting was performed in 1 patient(1.7%) for primary lesion, 50 patients(84.7%) for suboptimal results after PTCA, 6 patients(10.2%) for bail-out procedure, and 2 patients(3.4%) for restenotic lesions. All patients were treated with aspirin and ticlopidinc. The follow-up angiograms were obtained at 7±4 months. The overall in-stent restenosis rate was 27.1%. The coronary angiographic findings were 32 single vessel(54.2%), 19 two vessel(32.2%) and 8 three vessel disease(13.6%). The angiographic morphological characteristics were type A in 33(55.9%), type B in 14(23.7%), type C in 12(20. 3%) cases. Variables of 16 patients with restenosis were compared with those of 43 patients without restenosis. Previously known predictors for in-stent restenosis were multiple stenting, stenting for restenotic lesions, residual stenosis after stenting, stenting for total occlusion lesions, reference diameter, balloon to vessel ratio, acute gain and minimal luminal diameter after procedure, design and characteristics of stents, ostial lesion of aorta, high pressure method for stenting, lesion length, diabetes mellitus, size of artheroma, saphenous vein grafts, ulcerlating lesions and calcified lesions. In this study, Reference diameter before stenting(2.43±0.54mm vs. 2.88±0.65mm, p=0.016) and balloon-to-artery ratio(1.28±0.26 vs. 1.11±0.18, p=0.006) were predictors for in-stent restenosis. 1) The overall in-stent restenosis rate was 27.1%. 2) In the analysis of predictors for in-stent restenosis, there was no significant differences in clinical, angiographic factors between group with restenosis and without restenosis. But, Only reference diameter before stenting and balloon-toartery ratio were predictors of late in-stent restenosis. In conclusion, stenting is effective revascularisation method for selected patients with ischemic heart disease, and to minimize in-stent restenosis rate, stent implanting is achieved in a large vessel on the basis of an artery-to-stnet ration of 1:1, if possible.

간세포암에 대한 화학 색전 및 주입 요법 후에 발생한 발열과 감염성 합병증에 관한 전향적 연구

김양수,이상오,이미숙,정두련,김은옥,정영화,우준희,이영상,서동진,성규보,류지소,고기영 대한감염학회 1998 감염 Vol.30 No.3

목적 : 간동맥 화학 색전 및 주입 요법을 시행 받은 환자에서 시술 후 나타나는 발열 및 감염성 합병증의 빈도와 특성을 관찰하고, 이들 중 감염성 합병증이 발생한 환자들을 미래 예측할 수 있는 임상적 지표들이 있는 지 알고자 하였다. 방법 : 1997년 6월부터 8월까지 간세포암으로 간동맥 화학 색전 및 주입 요법을 시행받은 환자들을 대상으로 전향적으로 조사하였다. 화학 색전 및 주입 요법 시행 후 발열이 발생하였으나 감염 및 간 회 색전증의 증거 없이 자연히 소실된 경우에 한해 색전술 후 증후군이라고 정의하였다. 결과 : 284명에서 303예의 시술(화학 색전 요법 200예, 주입 요법 103예)이 시행되었다. 이중 108예(35.6%)에서 시술 후 발열이 있었다. 발열의 원인으로 감염성 합병증이 7예 (2.3%), 허혈성 담낭염이 5예(1.7%)였고 1예는 분류가 힘들어 나머지 95예(31.4%)를 색전술 후 증후군으로 분류하였다. 감염성 합병증은 배양 음성 중성구성 복수(culture-negative neutrocytic ascites)가 3예, 원발성 세균성 복막염이 2예(이중 1예는 패혈증 동반), 패혈송 쇽이 1예, 요로 감염증이 1예이었다. 색전술 후 증후군은 발열이 없었던 군에 비해 복수가 있거나(odds ratio [OR], 2.74; 95% contidence interval [CI], 1.30∼5.75) 종양이 클수록 (OR, 1/15; 95% CI, 1.06∼1.24), 도한 좌우 감동맥을 모두 막은 경우 (OR, 1.81; 95% CI, 1.00∼3.28) 빈번하게 발생하였다. 감염성 합병증일 때에는 색전술 후 발열이 있으면서 systemic inflammatory response syndrome(SIRS)의 기준을 만족하거나 (p<0.05) 시술 후 72시간 이후에 복부 동통이 발생하는 경우가 많았다.(p<0.01). 그러나 발열 시 감염을 미리 구별할 수 있는 검사실 소견은 없었다. 결론 : 간세포암에 대한 화학 색전 및 주입 요법 후 색전술 후 증후군은 31.4%, 감염성 합병증은 2.3%에서 발생하였다. 색전술 후 발열이 있으면서 SIRS의 기준을 만족하거나 시술 후 72시간 이 후에 복부 동통이 발생할 때에는 감염성 합병증을 반드시 고려해야 하겠다. Background : Transarterial chemoembolization(TACE) and chemoinfusion (TACI) are the methods used increasingly in hepatocelluar carcinoma patients. In this study, the incidence of fever and infectious complications after TACE or TACI in pateints with hepatocellular cacinoma was investigated and clinical parameters predicting such complications were evaluated. Methods : Prospective surveys were done in hepatocelluar carcinoma patients who had undergone TACE or TACI from June August, 1997. Three hundred three treatment cases with TACE (200) or TACI (103) in 284 patients were analyzed. The postembolization syndrome was defined as fever following TACE or TACI that spontaneously subsided without the evidence of infections or extrahepatic emboilizations. Results : One hundread eight (35.6%) out of 303 cases showed fever after the treatment. Regarding the etiology of the fever, after the treatment. Regarding the etiology of the fever, infections occurred in 7 cases (2.3%), and ischemic cholecystitis existed in 5 cases (1.7%). In one case the cause was not clear and 95 cases (31.4%) were classified as the postembolization syndrome. Out of the infections, three had culture-negative neutrocytic scites, two spontaneous bacterial peritonitis (one was accompanied with sepsis), one septic shock, and one urinary tract infection. The postembolization syndrome was more frequently found in the cases with ascites (odd ratio [OR], 2.74; 95% confidence interval[CI], 1.30∼5.75), with larger tumor (OR, 1.15; 95% CI, 1.06∼1.24) and with embolization both hepatic arteries (OR, 1.81; 95% CI, 1.00∼3.28). In the cases with infections, many satisfied the criteria for systemic inflammatory response syndrome (SIRS, P<0.05) or had abdominal pain 72 hours later (P<0.01) after the treatment. However, no other laboratory data predicted infection among the cases with fever. Conclusion : After TACE or TACI in hepatocellular carcinoma patients, 31.4% of cases showed the postembolization syndrome and 2.3% of cases showed infection. Infection should be considered as a cause of fever in patients satisfying the criteria for SIRS or with abdominal pain 72 hours later after the treatment.

혈액 투석 환자에서 중심정맥 협착에 대한 스텐트 삽입술 : Wallstent Placement

임대승,노상필,이유선,정승현,김보영,이정우,강정아,김정희,이민수,정준용,최시완,정진옥,성인환,이강욱,신영태 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.

인터넷 중독 고위험 청소년의 성별에 따른 임상적, 정신병리적 특성

이지윤(Ji Yoon Lee),권준근(Jun-Gun Kwon),이준영(Jun-Young Lee),정희연(Hee Yeon Jung),손보경(Bo Kyung Sohn),최삼욱(Sam Wook Choi),김대진(Dai Jin Kim),최정석(Jung-Seok Choi) 한국중독정신의학회 2016 중독정신의학 Vol.20 No.1

Objectives : Most previous studies of Internet addiction (IA) have been performed on males, and little is known about gen-der differences in IA. We examined gender differences in the clinical and psychopathological features related to high-risk for IA among adolescents. Methods : 714 (male : N=389 ; fe-male : N=325) have reported questionnaires as follows ; 1) clinical and psychopathological features (depression, anxiety, Attention Deficit Hyperactivity Disorder (ADHD) symptoms, Smartphone addiction, impulsivity, behavioral inhibition and approach systems, state-trait anger, aggression, beliefs about aggression, and resilience) 2) Internet and Smartphone usage patterns. In 691 who completed the Young’s Internet Addiction Test (YIAT), A total of 487 adolescents were classified into the normal Internet use group, with YIAT scores of 20-39 (male :N=232 ; female : N=255) and 204 adolescents were classified into high-risk for IA group (male : N=144 ; female : N=60). Results : Most factors described above predicted high-risk for IA in male and female adolescents. Especially, the present study found that psychological resilience had negative association with possibility of IA in female, while cognitive impulsivity and hostile aggression were associated with possibility of IA in male adolescents. Conclusion : This study found gender-re-lated features in adolescents at high-risk for IA. Thus, gender-specific strategies are needed to maximize prevention and treatment effectiveness of IA.

소득작물 전후작지 적응 극단기성 벼 ‘중모 1032’

손영보,이종희,조준현,이지윤,오성환,송유천,박동수,박노봉,김상열,여운상,남민희,권영업 忠北大學校 農業科學硏究所 2015 農業科學硏究 Vol.31 No.2